Related Experiment Video
Updated: Oct 30, 2025
12:08
Rapid Antimicrobial Susceptibility Testing by Stimulated Raman Scattering Imaging of Deuterium Incorporation in a Single Bacterium
Published on: February 14, 2022
3.0K
Uninterpretable cerebrospinal fluid absorbance scans caused by antibiotic therapy
1Hallands Sjukhus Halmstad, Halmstad, Sweden.
Annals of Clinical Biochemistry
|July 2, 2021
Summary
Antibiotics like doxycycline and tetracycline can interfere with cerebrospinal fluid bilirubin analysis, potentially masking subarachnoid hemorrhage. Visual inspection of cerebrospinal fluid samples is recommended to ensure accurate diagnosis.
Area of Science:
- Clinical Chemistry
- Neurology
- Diagnostic Medicine
Background:
- Revised UK guidelines offer objective cerebrospinal fluid (CSF) analysis for subarachnoid hemorrhage (SAH) risk.
- Antibiotic interference, particularly doxycycline, can render CSF samples uninterpretable.
- This study investigates further cases of antibiotic interference in CSF analysis.
Purpose of the Study:
- To identify and characterize antibiotic-based interference in CSF bilirubin analysis.
- To assess the clinical implications of such interference.
- To recommend diagnostic best practices.
Main Methods:
- Archival search of CSF spectra (2011, 2016-2019) at Hallands County Hospital Halmstad.
- In vitro reproduction experiments to confirm interference and assess clinical impact.
- Analysis of 10 cases of suspected CSF curve interference.
Main Results:
- Ten cases of CSF curve interference were identified: six doxycycline, three metronidazole, one tetracycline.
- Tetracycline-class antibiotics caused an apparent decrease in net bilirubin absorbance.
- Visual xanthochromia remained detectable despite spectral interference.
Conclusions:
- Antibiotic interference in CSF analysis may be more common than previously thought.
- Tetracyclines can lower apparent bilirubin absorbance, potentially affecting SAH diagnosis.
- Routine visual examination of CSF samples is recommended to mitigate diagnostic errors.
